Post Coronary Bypass Atrial Arrhythmic Prediction Rule

冠状动脉搭桥术后房性心律失常预测规则

• 批准号: 6668601
• 负责人: ROD S PASSMAN
• 金额: $ 12.3万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6668601
• 关键词: arrhythmia; atrial fibrillation; cardiovascular disorder epidemiology; cardiovascular disorder risk; clinical research; coronary bypass; electrophysiology; human subject; method development; outcomes research; patient oriented research; postoperative complications; prognosis; statistics /biometry

DESCRIPTION (provided by applicant): The proposed study seeks to develop and validate a clinical prediction rule for post-coronary artery bypass grafting (CABG) atrial fibrillation and atrial flutter (AF). These arrhythmias occur in 20-40% of the 500,000 patients undergoing CABG, and increase the morbidity, cost, and length of stay associated with the procedure. Though several studies have suggested that prophylactic therapy with beta-adrenergic blockers decreases the risk of post-CABG AF, this efficacy has not been universally appreciated. As a result, several new prophylactic therapies have been introduced, though some with significant toxicities associated with them. It is therefore imperative to identify a priori those individuals most at risk of developing post-CABG AF, as well as those unlikely to develop this endpoint. In this manner, those individuals most at risk of developing post-CABG AF may be targeted for prophylactic therapy, while those in a low risk category may be spared the exposure to a potentially deleterious therapy from which they are less likely to derive benefit. Additionally, the identification of a high-risk subgroup would allow for the execution of smaller randomized controlled trials, and may provide insight into the etiology of post-CABG AF. The study is a retrospective cohort study designed to identify pre-, intra-, and post-operative variables which may be associated with post-CABG AF. From these results, a clinical prediction rule will be formulated. Validation of the prediction rule will then take place in a prospective cohort study using a different group of patients from which the rule was derived. This will allow for the assessment of both validity and generalizability. The candidate has committed himself to a career as an independent investigator, with an interest in the application of rigorous epidemiologic techniques to questions of importance in cardiac electrophysiology, his area of clinical expertise. This project will be an integral part of the candidate?s career development plan and his maturation as an epidemiologist, cardiac electrophysiologist, and clinical investigator.

描述(由申请人提供)： 这项拟议的研究旨在开发和验证临床预测规则 适用于冠状动脉旁路移植术(CABG)后的心房颤动和心房 颤动(AF)。这些心律失常发生在50万名患者中的20%-40% 接受冠状动脉搭桥术，增加了发病率、费用和住院时间 与该程序相关联。尽管有几项研究表明 使用β-肾上腺素能阻滞剂进行预防治疗可降低 冠状动脉旁路移植术后的房颤，这一疗效并未得到普遍认可。作为一名 结果：目前已有几种新的预防治疗方法问世，尽管有些 以及与之相关的严重毒性。因此，这是当务之急 先验地确定哪些人最有可能发展为冠状动脉搭桥术后 房颤，以及那些不太可能发展这一终点的人。这样一来，那些 冠状动脉搭桥术后房颤风险最高的个人可能成为 预防治疗，而那些低风险类别的人可能会免于 接受一种可能有害的治疗，而他们不太可能从中受益 以获取利益。此外，高危亚群的识别 将允许执行较小的随机对照试验，并且可以 深入了解CABG术后房颤的病因。 这项研究是一项回溯性队列研究，旨在确定 以及可能与CABG术后房颤相关的术后变量。从… 这些结果，将制定临床预测规则。验证 然后，预测规则将在一项前瞻性队列研究中使用 得出该规则的不同患者组。这将允许 用于有效性和概括性的评估。 这位候选人致力于独立人士的职业生涯。 调查员，对严格流行病学的应用感兴趣 心脏电生理学中重要问题的技巧 临床专业领域。该项目将是 候选人？S的职业发展规划和他作为流行病学家的成熟， 心脏电生理学家和临床研究员。